Anat Cell Biol.  2022 Sep;55(3):284-293. 10.5115/acb.22.053.

Study of course and termination of brachial artery by dissection and computed tomography angiography methods with clinical importance

• Shetty H
• Patil V
• Mobin N
• Narayana Gowda MH
• Puttamallappa VS
• Vamadevaiah RM
• Kunjappagounder P

• KMID: 2533352
• DOI: http://doi.org/10.5115/acb.22.053

Abstract

The Brachial artery is a continuation of the axillary artery, from the inferior border of the tendon of teres major to the neck of the radius, terminating into radial and ulnar arteries just a cm distal to the elbow joint. Unlike veins, variations in the arteries are comparatively less common. Anatomical variations of the brachial artery occur in almost 20% of the cases and are commonly found during routine dissection or clinical practice. To observe the variations in the course and termination of brachial artery by dissection and computed tomography (CT) angiography methods. The present study was conducted on 40 upper limbs each in the department of Anatomy & Radiology of JSS Medical College and Hospital, Mysuru. The brachial artery was traced from origin to termination and variations were noted and photographed. Patients who were undergoing CT angiography of the upper limbs in JSS Hospital were included in the study. Variations noted and compared with the dissection method. In the present study, normal patterns of the brachial arterial course and termination were observed in 31 specimens. The remaining 9 specimens showed variant course and termination in the brachial artery like an unusually tortuous superficial brachial artery, superficial brachio-ulnar artery and brachio-radial artery. CT angiography showed 6 variations and a tortuous brachial artery. A detailed description of the vascular pattern of upper limbs especially variations in their origin and termination is of extreme importance in clinical practice. The knowledge of these variations is important for catheterization, graft harvesting, arteriovenous fistula creation, shunt application and astrup examination.

Keyword

Brachial artery; Superficial brachial artery; Superficial brachio-ulnar artery; Brachioradial artery; Tortuosity

Figure

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  Fig. 1 Right upper limb showing unusually TSBA. TSBA, tortuous superficial brachial artery; MN, median nerve; RA, radial artery; UA, ulnar artery.

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  Fig. 2 Left upper limb showing TSBA. TSBA, tortuous superficial brachial artery; RA, radial artery; UA, ulnar artery; MN, median nerve.

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  Fig. 3 Right upper limb showing TSBA. TSBA, tortuous superficial brachial artery; RA, radial artery, UA, ulnar artery; MN, median nerve.

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  Fig. 4 Right upper limb showing TSBA. TSBA, tortuous superficial brachial artery; RA, radial artery; UA, ulnar artery; MN, median nerve.

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  Fig. 5 Left upper limb showing SBUA or high origin of ulnar artery. SBUA, superficial brachio-radial artery; BA, brachial artery; MN, median nerve; PBA, profunda brachii artery, UN, ulnar nerve.

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  Fig. 6 Right upper limb showing high origin of ulnar artery from axillary artery. LRMN, lateral root of the median nerve; MRMN, medial root of the median nerve; SBUA, superficial brachio-radial artery; MN, median nerve; BA, brachial artery.

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  Fig. 7 Left upper limb showing brachio-radial artery or high origin of radial artery. SBRN, superficial branch of radial nerve; HORA, high origin of radial artery; MN, median nerve; BA, brachial artery.

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  Fig. 8 Right upper limb showing brachio-radial artery or HORA. HORA, high origin of radial artery; MN, median nerve; BA, brachial artery.

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  Fig. 9 Left upper limb showing brachio-radial artery or HORA. HORA, high origin of radial artery; BA, brachial artery.

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  Fig. 10 Computed tomography angiography images showing brachio-radial artery and tortuous brachial artery. (A) High origin of radial artery, (B) high origin of radial artery. RA, radial artery; BA, brachial artery.

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  Fig. 11 Schematic representation of developmental basis for SBA that continues as radial artery. AA, axis artery; UA, ulnar artery; BA, brachial artery; SBA, superficial brachial artery; IA, interosseous artery; RA, radial artery.

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  Fig. 12 Schematic representation of developmental basis for SBUA. AA, axis artery; SBUA, superficial brachio-ulnar artery; BA, brachial artery; SBA, superficial brachial artery; IA, interosseous artery; RA, radial artery.

Reference

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